World Economic Forum Warns That Patents Are Making Us Lose The Race Against Antibiotic-Resistant Bacteria

from the people-are-beginning-to-talk dept

Back in June last year, Techdirt reported on the warning from the World Health Organization's Director-General that we risked entering a "post-antibiotic era". That was in part because the current patent system was not encouraging the right kind of research by pharma companies in order to develop the new antibiotics that we desperately need.

Arguably, one of the most effective and common means to protect human life -- the use of antibacterial and antimicrobial compounds (antibiotics) -- may no longer be readily available in the near future. Every dose of antibiotics creates selective evolutionary pressures, as some bacteria survive to pass on the genetic mutations that enabled them to do so. Until now, new antibiotics have been developed to replace older, increasingly ineffective ones. However, human innovation may no longer be outpacing bacterial mutation. None of the new drugs currently in the development pipeline may be effective against certain new mutations of killer bacteria that could turn into a pandemic.

Those experts also offered their views on why they thought this worrying situation had come about. Their answer turned out to be the same as the key problem outlined in the earlier Techdirt story -- the failure of patents to encourage the development of drugs that maximized public health rather than private profits:

respondents to the Global Risks Perception Survey connected antibiotic-resistant bacteria to failure of the
international intellectual property regime. This global risk is defined in the survey as "the loss of the international intellectual property regime as an effective system for stimulating innovation and investment" -- that is, going beyond the mechanisms of protecting IP to encompass the idea that the ultimate purpose of the IP system is to stimulate worthwhile innovation. The connection highlights a global market failure to incentivize front-end investment in antibiotic development through the promise of longer-term commercial reward, a failure which also applies to drugs to fight malaria and vaccines for pandemic influenza.

Rather than today's monopolistic hoarding, what we need is more sharing of knowledge, the Global Risks Report suggested:

There is also potential to use public or philanthropic funding to incentivize academic collaboration with pharmaceutical industry researchers, and more inter-company collaboration as well. Breakthroughs in antibiotic innovation will require pooling and
sharing of knowledge among academia, private companies and government regulators. Companies and foundations like GlaxoSmithKline (GSK) and the Bill and Melinda Gates Foundation are pioneering an "open-lab" approach to research which refutes the idea that secrecy and patented monopolies are the bedrock of innovation.

Given Microsoft's fervent assertions of precisely this idea, there is a certain irony in a Bill Gates-funded organization being praised for refuting it.

We are entering a post antibiotic era because doctors keep prescribing them for every little ailment so that they are losing their effectiveness against the conditions they are meant to fight. Doctors need to stop handing them out like sweets.

The real problem is those bacteria who are mutating outside our patent system. They are stealing from the pharmaceutical companies trying hard to patent new drugs! We should create a national bacterial database and require they register all new mutations.

doesn't matter. as far as the UK government is concerned, there will be more deaths so less money to pay out in pensions. that will also lead to the £20,000 pay rises UK MPs say they want being available. not bad when one of the biggest scroungers and laziest bastards there is in the UK (IDS) is in the government and taking even more money from those trying to live on next to fuck all already! the coalition has forgotten that it wasn't voted in to just try to reduce the so-called deficit, but to do the best it can for the people as well. that last bit has gone right down the toilet!!

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I tend to agree. While I agree with the points about patents slowing our march towards ever more powerful antibiotics, I think that the approach itself does stimulate evolution of stronger and stronger bacteria. Escalating the conflict to the point we are at now kind of illustrates a certain ignorance of the realities of evolution.

It just goes to show it is possible to completely understand something in theory or in study, and completely unappreciate the nature of it in real life. In this case the misunderstanding is epidemic.

While I would say that there is the other issue of the over-perscription of antibiotics for mundane sicknesses (or inappropriate sicknesses that antibiotics do nothing to help such as colds and flu) that can cause the breeding of superbugs, generally speaking if you prevent people carrying out R and D due to patents you are taking a massive risk.

The patent system needs to be socialised - tax people who wish to copy inventions instead of allowing the inventors to discriminate who gets a patent licence based on price or other nonsense. And give the taxes straight to the inventors. It also means less chance of them trying to cheat the system and extend patent terms on false premises.

There is no avoiding the fact that scientific development is a social issue, so you may as well embrace it in a Socialist direction. Patents are just indirect taxation where the money does not touch the vaults of the government. While Libertarians may argue that is a good thing, it would seem pretty easy to avoid corruption by giving the taxed and those receiving the tax receipts to allow the money to be followed.

As long as all of humanity can benefit from scientific research, it deserves to be a human right, strongly suggesting a Socialist imperative.

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... I think that the approach itself does stimulate evolution of stronger and stronger bacteria.

That seems to be the biggest issue. Antibiotics are over-prescribed and I don't think that has anything to do with the patent system. If anything, having more generics that everyone can cheaply put into animal feed and give everyone for whatever illness would likely accelerate the problem.

Also, the quote from the report says this:

The connection highlights a global market failure to incentivize front-end investment in antibiotic development through the promise of longer-term commercial reward, a failure which also applies to drugs to fight malaria and vaccines for pandemic influenza.

I'm not sure that eliminating patents addresses "the failure to incentivize front-end investment in antibiotic development through the promise of longer-term commercial reward."

I'm not suggesting that medical patents are good. I'm just pointing out that the report is says the reward system for scientific research is wrong, not that patents themselves were bad.

Rapid scientific progress requires the sharing of ideas and results, which includes failed experiments. Patents requires keeping ideas and development secret until the patent is gained. Scientists therefore exchange less information, and mainly the successful results. This results in slowed development of new ideas and drugs. This is not helped by patented compounds being off limits to others for their experiments.

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Abstinence is a short-term "Kick the ball into the future" and actually afaik MDR is a far worse problem in industrial production of animals, where restaint is a lot more warrented! Farmers are very likely to contract a MDR infection.

The problem on the long field is not the lack of potential drugs or their development. The problem is the lack of targeted drugs. If you develop a sweeping broad antibiotic, you hear "money, money, money". That is not what is needed to fight the new MDR bugs. Because we are using as much of the non-specific antibiotics they are useless against MDR.

The change from sweeping broad antibiotics to far more specific drugs will, if not completely eliminate the problem, make it a lot more rare.

The way to combat MDR in the foreseeable future is still antibiotics, but instead of overbroad antibiotics, they will have to be more and more specific. The first step is development in genera-specific biotics. Next step will be functional specific inhibitors. Afterwards, probiotics is likely to take over. In combination with specific inhibitors and targeted antibiotics, it is hands down a solution to the problems with antibiotics today.

The incentive system we have today makes it impossible to develop a cure for very rare ailments and making too specific antibiotics has the same problem. As long as it is impossible to see the future it is impossible to predict when it is good business to go with targeted antibiotics. Therefore, the primary argument against the drug patent system is that the incentive is for conservative cases primarily (it is incredibly efficient to create a cleaner variant of an older drug and patent that, than actually develop something new). It is also reserved for popular ailments.

Solutions to the incentive system for drug development are many, but it is becoming more and more apparent that there needs to be a broader and less conservative approach in the business. Whether it is through special clauses, exemptions or alternative incentive structures is up in the air.

The problem is not necessarily a patent system. It is the incentives in it.

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The problem appears to have nothing to do with the patent system, as that system is regularly characterized here as anti-innovation. Rather, it appears to be related to a simple economic truth...small markets for specific drugs are not the type that companies typically seek out.

The commons and health

Stephan Kinsella is a libertarian and it is possible that global health care, like global warming, works better using a commons approach than a libertarian approach.

What one person/country does in the global system can have ramifications for everyone else, so a system based on everyone acting individually may not solve the problem.

The effectiveness of antibiotics depends on people only using them when appropriate and in the proper fashion. When people abuse them, we get superbugs that then become more dangerous for others, too. So finding solutions may require finding ways of curtailing people's freedom to use whatever medicine they want whenever they want to.

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When I was 22 years old, I was told the results of a physical showed I had the cholesterol levels of a 40 year old man. I blame it largely on a bad fast food diet (always a skinny person so I didn't consider the risks, or didn't take them seriously).

The unnerving thing is that I was immediately being prescribed meds. Before I left I asked "Can't you lower your cholesterol through diet and exercise?". The doctor turned around and was like... oh... well, yeah. I had to basically beg for information on how to attack my condition without medication. I just think it is somewhat disturbing that it doesn't cross a doctor's mind that a 22 year old man can diet and exercise.

A physical done two years later showed no signs of elevated cholesterol whatsoever. Had I said nothing, I would probably still be shoving pills down my face.

Re: The commons and health

I'll add that the very idea of "selling" medicine might be the wrong one to begin with. If people need antibiotics, particularly to prevent epidemics, then those drugs need to get properly distributed whether or not there is a profit for the discoverers or the businesses that make them.

So a system that depends on for-profit companies doing the research and manufacturing of drugs might be the wrong model.

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I think that's a major issue with letting the private sector manage health.

Certain health issues have not short-term gain or even possibly long term gain for a single company, but there is a huge long term gain for the economy as a whole, it the form of unpaid debts and reduced GDP.

The private sector's goals do not align with society in many health related issues.

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Changing to targeted drugs is not necessarily bad business. If you have a relatively well-functioning immune system it is rather specific what bugs can hit you and thus it has a strong business-case for certain bugs. Only problem is that detection of infections is a bitch still, so the companies do not have enough data to actually know what to send to market and the doctors do not get enough time to identify the infection. At the same time, studies on what the infections are, is limited to universities since it is bad business for companies to do basic research.

The true problem with patents is that it rubs universities the wrong way. Heck, universities are specifically exempted from the system!

Specific detection of infections is an area where companies steal pHds from universities before they finish (I have seen more than one case of that!), but the methods are still "too expensive", "too imprecise", "too slow" and/or "already out of patent", so... While patents are not the primary reason for the problem - and it is definately not "only anti-innovation" - it is not an innocent bystander to the situation or a useful incentive for the more basic science. It is sepcifically a hinderance to the shift in behaviour that is needed because it incentivises scientist to improve on the companys own innovation instead of actually innovating.

As for solutions: The governments in the western world has already chosen to "implement" patents on universities. Problem is that as a student you can almost give yourself a secure job by improving the brass lamp, while true basic science puts you back in line unless you want to stay at the university. Because it takes a lot of money to get the patent office at the university rolling and they have to make up that loss somehow, guess what students are incentivised to do now?

While the basic principles of the patent system actually has a positive incitament to go Citius, Altius, Fortius, it is not good for fundamental science and thus the potential for true innovation as opposed to improvement of the existing.

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It doesn't matter that much. "When in Rome etc."
The system dictates ROI as the name of the game. While many newcomers may be principled individuals they will realise that you are in a competition and any "waste of money" is bad business and the economic division will push for principles to go in the name of certain pieces of paper. Some might hold on to the belief 'till they die, but the predecessor will likely be more "open to reason". Given the age of the 256 companies sitting on most of the worlds capital I think you can see where I am going?

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Capitalism needs to be questioned as its great flaw is perpetual growth in the quantity and of products in a world where production is automated, markets are starting to saturate, and population may be starting to stabilise.

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Capitalism needs to be questioned as its great flaw is perpetual growth in the quantity and of products in a world where production is automated, markets are starting to saturate, and population may be starting to stabilise.

That's the sort of economic reading I've been doing for the last few years.

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Scientist hate it because they loose a percentage of their grants to keep the universitys patent office afloat where I come from (it is up to 50% they loose to the patent office!).

As for exemption your wording is better yes, but I would argue that it is still a pretty significant exemption from having to pay royalties to do researh with these techniques. Often companies are also willing to cooperate for free to see what students can find out about their invention. Again, it falls far outside the patent systems grap.

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The amount of health-related taxes, bans, detail regulation and special grants from semi muddy hands we see in Denmark can make the "totally committed" to approach "totalitarian committed". It has gone too far as to allow DNS-blocking of pharmacy sites and gambling sites (getting retracted) and building a road is no longer as much of a technical sciense as it is a legal science! And dont get me started on the agriculture industry where there are at least 2 people administering the rules around it for each farmer (My numbers are old and the amount of laws have rissen a lot so it might be closer to 3)!

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This is true. But scientists are not universities, and have different priorities.

I would argue that it is still a pretty significant exemption from having to pay royalties to do researh with these techniques.

It's a significant exemption, and a necessary one if patents are to fulfill their stated purpose. I don't think it's significant in terms of how universities view the idea of patenting things, though.

It's really no different than the exemption you & I have. Patent limits commercial use. Research isn't commercial use. We are all free to use any patented technology we want without paying royalties. We just can't market products or services that contain them. It's the same with universities.

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With the universities entry into taking patents I would strongly disagree on them not being commercial. Research attached with a patent is research attached with a patent no matter if it is made in a R&D department or at a university. The patent is enough to make it a part of the business and only the partners in patenting will see them as allies in this regard. The rest will see the patent as a competitor and therefore a commercial entity.

That is one of the fundamental reasons why I disagree with patents on universities. It changes the situation for universities from a potential low cost, low reward neutral entity to a potentially medium cost, medium reward NPE. By going from neutral entity to a NPE, universities are becoming a biased part of the business world and actually in the same group as most trolls (also likely to take a hit from some measures against the trolling). It might attract more company capital and therefore tax-neutral funding, but it is at a high cost in far more strings attached and a massively lower priority to fundamental research (cost of keeping the patent office afloat, students choosing company projects and in the longer term, a decline in percieved integrity because of the competition elements introduced).

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You missed the other problem with universities getting into patents, keeping the research secret until the patent is obtained. Prior publication invalidates a patent, even if it is by the patent application.
This goes against the original academic principle of sharing result, data and methods. Richard Stallman founded the Free Software Foundation after Universities and their collaborators stopped sharing source code. This marked the point where academia started to turn away from open research.

more dissembling

"Rather than today's monopolistic hoarding, what we need is more sharing of knowledge"

Do you know how to make a Stradivarius violin? Neither does anyone else. Why? There was no protection for creations in his day so he like everyone else protected their creations by keeping them secret. Civilization has lost countless creations and discoveries over the ages for the same reason. Think we should get rid of patents? Think again...or just think!

They sell blog filler and "insights" to major corporations including MS, HP, IBM etc. who just happen to be some of the world’s most frequent patent suit defendants. Obviously, he has failed to report his conflicts as any reputable reporter would. But then Masnick and his monkeys are not reporters. They are hacks representing themselves as legitimate journalists receiving funding from huge corporate infringers. They cannot be trusted and have no credibility. All they know about patents is they don’t have any.

Drug companies..

are far more interested in PROFITS than in curing disease. They would much much rather make 10 million saving 5,000 lives than make 5 million saving 50,000 lives. Profit is the only thing they care about

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A major problem is, as you said, that we allow a lot of bacteria to exist so that many mutations may arise. This process is never-ending, true. It is made worse in general if we use humans as hosts (or "nearby" species hosts) since here we are allowing all the mutations that hurt us most to survive and dominate other mutations since the bad ones are the ones most promoted within our bodies (which presumably can extinguish the others more easily). And by periodically using drugs to scale back bacteria but leaving a lot in place, we keep many of the precursor mutations going with more and more chances to further mutate into deadly forms.

One part of the solution is obviously then to avoid overuse of medicines carelessly. However, that is addressed with separate public policy. Price of the medicines has little to do with it. Heck, the medicines could be over the counter and taxed at $100 per tablet and that would easily create a greater deterrent price effect than do patents (which don't aim to discourage overuse but simply to find the sweet price point to maximize profits).

In contrast to this misuse problem, a broken patent system diverts research and production resources into other areas, and this diversion of resources is a second important and independent problem and is the topic discussed above.

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Sorry. Rereading your comment more carefully, I think I would agree with most of it.

I do think however that the group's conclusion suggests that patents as written into law are not as good overall as some have assumed they are given how they fail in such an important area so closely associated with promoting the progress.

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The problem appears to have nothing to do with the patent system, as that system is regularly characterized here as anti-innovation. Rather, it appears to be related to a simple economic truth...small markets for specific drugs are not the type that companies typically seek out.